Find 2019 Medicare Plans in New Jersey - NJ Medicare Insurance Overview

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New Jersey Medicare Insurance

Medicare in New Jersey

Medicare offers healthcare coverage to New Jersey residents age 65 or older, or to those New Jersey residents that suffer from certain medical disabilities. In 2016, 1,450,000 people are enrolled in Medicare in New Jersey, accounting for 16.4% of the population in New Jersey. About $11,903 was spent per Medicare enrollee in New Jersey in 2009, approximately 14.84% higher than the national average of $10,365 and the highest amount spent on each beneficiary out of all 50 states and Washington, D.C. From 2015 to 2030 the senior population in New Jersey is projected to increase by an estimated 41.47% according to calculations based off of the 2000 Census. Thus the number of Medicare beneficiaries in New Jersey is also expected to increase.

Local Medicare Resources

Medicare beneficiaries and their caretakers can receive free, personal, unbiased counseling regarding any questions they have about benefits, claims, supplement policies, and long-term care insurance. Counseling is funded by New Jersey’s State Health Insurance Assistance Program (SHIP). Furthermore, New Jersey participates in a national Senior Medicare Patrol (SMP) program which aims to educate individuals on how to detect, avoid, and report instances of Medicare waste, fraud, and/or abuse.

Types of Medicare Coverage

When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). Keep in mind that you must be eligible for Original Medicare in order to enroll in a Medicare Advantage plan. If you enroll in Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Many Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.

New Jersey 2017 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2017 Medicare Advantage plan in New Jersey is $70.78, 13.28% greater than the national average of $62.48. 31.47% of 2017 Medicare Part C insurance plans in New Jersey have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $400, but in New Jersey the average annual drug deductible for Medicare Part C insurance plans with drug components is $215.21. 27.89% of 2017 Medicare Part C insurance plans with a drug component in New Jersey have a $0 annual drug deductible.
  • The average total monthly premium for a 2017 Medicare Advantage plan without a drug component in New Jersey is $14.74. 78.57% of 2017 Medicare Part C insurance plans without a drug component in New Jersey have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in New Jersey is $6,312.5. 6.03% of 2017 Medicare Advantage plans in New Jersey had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in New Jersey was 3.8 stars in 2017.
  • Among New Jersey's 2017 Medicare Advantage plans with CMS star ratings:
    • 2.59% earned a score of 5 stars
    • 55.17% earned a score of 4 or 4.5 stars
    • 31.03% earned a score of 3 or 3.5 stars
    • 1.72% earned a score of 2 or 2.5 stars
    • 9.48% of plans are “Not enough data available” or “Too new to be measured”.

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

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New Jersey Medicare Insurance Companies

There are 16 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in New Jersey. Of these, the companies that offer the largest variety of plans to choose from are Aetna, Humana, and UnitedHealthcare. In New Jersey,Oxford has the largest selection of Medicare Advantage plans while Humana offers the most Medicare Part D plans. The following are all medicare insurance providers in New Jersey:

Aetna

13 Plans

Humana

11 Plans

WellCare

3 Plans

Cigna

3 Plans

UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY

2 Plans

OMAHA HEALTH INSURANCE COMPANY

2 Plans

Amerigroup

2 Plans

MERIT HEALTH INSURANCE COMPANY

1 Plans

2019 Featured Medicare Plans in New Jersey

There are 69 medicare plans in New Jersey. The following are the 10 highest rated medicare plans in New Jersey based on their CMS rating for the plan's overall quality.

Monthly CostPlan NameCMS Rating
from $48UnitedHealthcare - Erickson Advantage Freedom (HMO-POS) - Monmouth County
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from $160UnitedHealthcare - Erickson Advantage Signature without Drugs (HMO-POS) - Monmouth County
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from $195UnitedHealthcare - Erickson Advantage Signature with Drugs (HMO-POS) - Monmouth County
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from $0Humana - HumanaChoice H5216-183 (PPO) - Burlington County
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from $0Humana - HumanaChoice H5216-174 (PPO) - Bergen County
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from $0Humana - HumanaChoice H5216-185 (PPO) - Burlington County
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from $0Humana - HumanaChoice H5216-172 (PPO) - Bergen County
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from $0Humana - HumanaChoice H5216-169 (PPO) - Bergen County
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from $28Aetna - Aetna Medicare SNJ Prime Elite Plan (PPO) - Burlington County
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from $29Humana - HumanaChoice H5216-170 (PPO) - Bergen County
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See all Medicare plans in New Jersey

New Jersey Featured Medicare Plans for Managing High Blood Pressure

The following are the 5 highest rated medicare plans in New Jersey based on their CMS rating for the plan's ability for controlling high blood pressure.

Monthly CostPlan NameCMS Rating
from $195UnitedHealthcare - Erickson Advantage Signature with Drugs (HMO-POS) - Monmouth County
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from $160UnitedHealthcare - Erickson Advantage Signature without Drugs (HMO-POS) - Monmouth County
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from $48UnitedHealthcare - Erickson Advantage Freedom (HMO-POS) - Monmouth County
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from $167Aetna - Aetna Medicare Premier Plan (HMO) - Bergen County
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from $81Aetna - Aetna Medicare Standard Plan (HMO) - Atlantic County
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New Jersey Featured Medicare Plans for Managing Diabetes

The following are the 5 highest rated medicare plans in New Jersey based on their CMS rating for the plan's ability for diabetes care including: eye exam, kidney disease monitoring, blood sugar controlled and cholesterol controlled.

Monthly CostPlan NameCMS Rating
from $195UnitedHealthcare - Erickson Advantage Signature with Drugs (HMO-POS) - Monmouth County
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from $160UnitedHealthcare - Erickson Advantage Signature without Drugs (HMO-POS) - Monmouth County
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from $48UnitedHealthcare - Erickson Advantage Freedom (HMO-POS) - Monmouth County
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from $66Aetna - Aetna Medicare NJ Silver Plan (Regional PPO)
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from $160Horizon Blue Cross Blue Shield of New Jersey - Horizon Medicare Blue (PPO) - Sussex County
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New Jersey Featured Medicare Plans for Managing Rheumatoid Arthritis

The following are the 5 highest rated medicare plans in New Jersey based on their CMS rating for the plan's ability for rheumatoid arthritis management.

Monthly CostPlan NameCMS Rating
from $78Aetna - Aetna Medicare Standard Plan (PPO) - Bergen County
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from $66Aetna - Aetna Medicare NJ Silver Plan (Regional PPO)
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from $28Aetna - Aetna Medicare SNJ Prime Elite Plan (PPO) - Burlington County
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from $198Horizon Blue Cross Blue Shield of New Jersey - Horizon Medicare Blue Choice w/Rx (HMO) - Atlantic County
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from $160Horizon Blue Cross Blue Shield of New Jersey - Horizon Medicare Blue (PPO) - Sussex County
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New Jersey Featured Medicare Plans for Managing Osteoporosis

The following are the 5 highest rated medicare plans in New Jersey based on their CMS rating for the plan's ability for osteoporosis management.

Monthly CostPlan NameCMS Rating
from $78Aetna - Aetna Medicare Standard Plan (PPO) - Bergen County
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from $28Aetna - Aetna Medicare SNJ Prime Elite Plan (PPO) - Burlington County
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from $81UnitedHealthcare - AARP MedicareComplete Plan 4 (HMO) - Bergen County
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from $75Clover Health - Clover Health Choice Premier (PPO) - Burlington County
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from $37Clover Health - Clover Health Choice Value (PPO) - Burlington County
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Most Popular Medicare Doctors in New Jersey

The following are the most popular medicare doctors in New Jersey based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
RadiologyEWING, NJ
Family MedicineNORTHFIELD, NJ
SurgeryMORRISTOWN, NJ
SurgerySOMERS POINT, NJ
RadiologyGALLOWAY, NJ
Internal MedicineUNION, NJ
SurgeryMORRISTOWN, NJ
RadiologyWEST ORANGE, NJ
RadiologyNUTLEY, NJ
DermatologyLAKEWOOD, NJ
See all doctors accepting Medicare in New Jersey

Browse Medicare Plans by Cities

  1. Newark, NJ
  2. Jersey City, NJ
  3. Paterson, NJ
  4. Elizabeth, NJ
  5. Edison, NJ
  6. Woodbridge, NJ
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